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4613 1_2 Penkwe Way 13161 rOffir° City o1 EaQall PI 3830 Pilot Knob Road : Eagan MN 56122 Date Received _ Phone: (651) 675-5675 I t Fax: (651) 675-5694 1 Staff I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: (f 3 `IC/ ? +-IGIj (~3r f2- J9 /ts- - ~Yi c Tenant: 011112 01 le- L S GP i7 " 4- Suite RESIDENT / OWNER Name: To 'e- r49&.n / ' hone: Address i City I Zip: Applicant is: Owner X Contractor+ TYPE OF WORK Description of work: Construction Cost: 1s-J7 ~ Multi-Family Building: (Yes / No CONTRACTOR Name: 0,* License ? I > '2 7.3 Address: 9 1 ' ' Zl 1j City: State: Zip: S 5.3 'l Phone: 612 5`?-- cy Contact Person: t) r' 2 I'' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Residential Ventilation Category I Worksheet - • New Energy Code Worksheet Category Submitted Submitted (I submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE-' • Plans aridsu ppot ing documents -,batybu submit are considered tobe public +nformation. Portions of the informptlon maybe classified as non-public if you provide spec ? sons that would perr+iitthe City to, c ~olude that iihe pare tiraiese I hereby acknowledge that this information is complete and accurate; that the work will be in c¢rlformanc a with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pla s ,~A raj x f l.~yyf x Applicant's Printed Name Signature Page 1 of 3 ILL DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace _ Porch (3-Season) - Storm Damage Single Family Garage - Porch (4-Season) - Exterior Alteration (Single Family) ~C3 Multi Deck _ Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi) 01 of Plex _ Lower Level Pool Miscellaneous Accessory Building WORK TYPES _ New - Interior Improvement Siding Demolish Building* _ Addition Move Building _ Reroof i Demolish Interior Alteration - Fire Repair _ Windows - Demolish Foundation Replace Repair * Egress Window - Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy C -3 MCES System Plan Review Code Edition ( ' z ' 1 SAC Units (25%100% Zoning City Water Census Code q3Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock wa Footings (Deck) Final I C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: Ice & Water _Final Pool: Footings Air/Gas Tests Final Framing Siding: -Stucco Lath -Stone Lath Brick Fireplace: _Rough In Air Test -Final Windows Insulation Retaining Wall Meter Size: Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee c~j~ • L' C~ +J M1$ 1 LAO iZ Surcharge , Ua 71 ~OcZ 'D~u 11>1-, y, Plan Review & ! 1 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL POW F F - or- Office -U-se Permit City of Eaaall Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2009 RESID TIAL BUILDING PERMIT APPLICATION ate: Site Address: manta Suite tESIDENT I OWNER Name: Phone: Address / City I Zip: Applicant is: Owner ontractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes I No ':ONTRACTOR Name: License Address: City: Stater Zip: Phone: Contact Pers : COMPLETE THIS AREA ONLY IF CONSTRUCTI G A NEW BUILDING Minnesota Rules 7670 Category I Minnesota Rules 7672 • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Submitted Submitted • Energy Envelope Calculations Submitted e City of Eagan issued a permit for a similar plan based on a master plan? d address of master plan: Phone: vo~ Phone: Phone: nts that you submit are considered to be public information. Portions of on-public if you provide specific reasons that would permit the City to ^lude that they are trade secrets. accurate; that the work will be in conformance with the ordinances and codes of the City of 'placation for a permit, and work is not to start without a permit: that the work will be in quires a review and approval of plans. rO Qa9e x Applicant's Signature Page 1 of 3 t -.--m`/y}~w~.~.~~..m.8.[ s"fit}c J U 8..i l ~a- S • °rl C. R. WINDEN & ASSOCIATES, INC. LAND SURVEYORS Tel. 645-3646 1381 EUSTIS ST., ST. PAUL, MINN. 55108 For: U. S. Home Corporation N EAGAN REVIEWED DATE: 417 L BUILDING INSPECTIONS DIVISION .G'Apec _ I r Scale: 1" = 50' ~2 ,i2 I 1 -3 C ~ w M~ ° I lu 22.33 22 'i3 > ~ V I W ~ ,1, _ 1a . rr 22 neap 'VtiM Lots 1 through 4 inclusive, Block 10, Johnny Cake Ridge Third Addition, Dakota County, Minnesota. WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. Doted thisday of Ocy, A. D. 198 / C. R. WINDEN & ASSOCIATES, INC. A d r by Surveyor, Minnesota Registration No. RESIDENT OWNER Name: d (L Caps C_L Phone: Lo T 13- J axo Address City Zip: L 4_013 1 17 Peri icuic L.ti -1 CONTRACTOR Name: NSVILLE HEATING A/C, INC. License #:C4 t, S3 .c1_, 11 3451 W. Burnsville Parkway Address: Suit 120 City: MN 55337 State: Zip: 9urnsville Phone:`► S F LJ -3 Contact Person: 6--N ra. TYPE OF WORK PERMIT TYPE New Replacement Additional Alteration Demolition Description of work: *1 0 RESIDENTIAL X Furnace COMMERCIAL New Construction Interior Improvement Install Piping Processed Air Conditioner Air Exchanger Gas Exterior HVAC Unit Heat Pump Under Above ground Tank Install Remove) When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector Other RESIDENTIAL FEES: $50.50 Minimum Add -on or alteration to an existing unit (includes $.50 State Surcharge) out appliances, ductwork, etc.) (includes $.50 State Surcharge) C �X` TOTAL FEE $90.50 Fire repair (replace burned COMMERCIAL FEES: $70.50 Underground tank $50.50 Minimum (includes installation /removal OR State Surcharge) surcharge is $.50. increases by $.50 for each $2,000 Permit Fee requires a $1.00 surcharge). Contract Value x 1% Permit Fee If Permit Fee is less than $1,000, State Surcharge If Permit Fee is $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001 TOTAL FEE C!tyofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 2009 MECHANICAL PERMIT APPLICATION Date —1?) -act Site Address: y L I :)--)t 12 PQfl t C LD Tenant: C.t kL Applicant's Printed Name x App iicant's Signature 1 Permit 1 (&c Permit Fee: Date Received: Staff: Suite I h ereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. S 399 PEWIT M 01122 DATE. 1 t!/ � n 1 46100,3- Rry 1 unit tnhse C Orrin Thompson Domes Units: Address. site Address: 4613 1/2 Penkwe Way L2 B10 J C Ridge 1I1 Plumber; i Jenze1 :leehanical. Meter No.: Connection Charge: 335.00 pd Size: Account Deposit: Reader No.: Permit Fee: 10.00 pd 1 agree to crisply with the City of Eagan Surcharge: .50 pd Ordinances. Misc. Charges: 60.00 pd meter Total: By Dote Date Paid D Date o Insp.. —' Z Insp.: CITY -A AGAN S R SERVICE PERMIT 879$ . Knob Read im;MNSa1ss P IT NO.: 1423 Zoning: RIV DATE: 12 18 / 31 Owner: Orrin Thom No. of Units: 1 unit ___ Address: Bon t3o�ti Site Address: 46133' Peukwe W 110.111111111.0 1 a‘ Plumber: Meehan : L Wenzel illiimmli B14 • J C d e III 14/19/81 2733 .• 1 *Poo to y with the. Cihr of ' � 00.00 pd Account Deposit: Permit Fee: _ 1 C QC D d B ,# Surcharge: 5C d Dote o � r-!i Misc. Charges: -- ----_' iee p .: _^____ — Z� l Total: Dote Paid: • F ' 1Y 3 1S' �� I�, �l9 l � �l�-, L�l �, �� ��� � J�- , Use BL13E or BLACK ir�k �----------------- i For Office Use � '} �t j Permit#: ' l I j ��1�� Q� �i���� ` U3.� � ��� � Permit Fee: � � 383U Pitot Knob Road ; Eagan MN 55122 1 Date Received: j Phone:t651)6i5-5675 t Staff: 1 Fax.(651)675-5894 � � - � .. . . . . . . .. .. .. .. . . . . .. . �. ��.���J . 20'1A� RESIDENTiAL BUlLDING PERMIT APPLICATION oac�: �-�I�`j`� s�naa�s:�6 l 3 1-!� l`5 �1� ��l��v� tv✓� un�t#: € Name: Ll!�/�l?i'a� ��1 �- !e�t,v��1,�^�r2� �Phane: � Resitlertt/ , owner aadress�c�Y��p: ,���"� ��-' ApPlicant is: Owner � Cont�actor � Description of work: �'Gv�''� ��� � �� '��o'�'� Type of Wor�€ < Constnaction Gost:��'i!�� � Mut�-Family Building:(Yes .� I No„_,_� � /" f( sy/ 4' Company:11/G�YZt/�.5 7� �,,�,7.f��r�r�t�'�t��5 '� Contad:��r s� �G�t��� C4t1#t�4'�A!' Address:���j� Z�`6?�/ �7� yr�Y� � City:l�l�'�t" t�tZl��'''�.-- 1� state:�z�p_ `'�.��`� Phone:�f��`"�'Emait:�+m��j.��-r,��:s7"�.c���"�'���"�� ir�R �7 ���_��r.�yl c� } {_IC@flS@� �� +tA � L@fld�Rf'�I�Ca�#:I�J�L°t""�..�1' j 1 f 6.�.? �! I�the project is exempt#rom lead ce�tification,please expiain v�►hy: (see Rage 3 for additional inforrnation) - COMPLETE THIS AREA ONLY IF CONSTRUCTiNG A NEW BUtLDING - !n the tast 72 miont , the City of Eagan issued a pertnit fcu a similar-planbased on a master ptan? � ,,rYes _No if yes,date and adctr f master plan: Llcensed Plumber: Phone: Mechanical Gontractor: , ; Sewer&Waber Co r. Phone: ``'��„p, ��1t7XE: ° s�r►r#suppc�r�r��s>c�m�rrts��Kaer submrt are�ansi�l�red'#o be publ�c ic�`e�r���r #�ns:�' � � � �. ,rnfareriatz���ra,��r�class�e�f as r#cc�r�-pubric if you pr�viai�specff�r�asax�s�woul�perm����`ta' co�cl�de tha�the �re+��i�s�cr��s GALL B�FORE YOU DIG. CaII GapherState One Calt at(651}454-0002 for protection againsf underground utility d�mage. Caii 48 hours 'i before you intend to dig to receive locates of underground utili6es. www.gonherstaTeonecali.oro i hereby acknowledge that this information is c�mp�te and aa�rate;that the work wii4 be in confarmance with ihe ordinanc�s and codes af the City of E�ar►;#fiat i understar�d this is not a pe�nit,but ortty an applicatian for a permit, and work is not to start wiihout a permlt;that the work-wi[I be in ac�ordance with the aPProved ptan in ft�case of uaark which requires a=eview ar�d approval of ptans. Exterior work autMorized by a bulldi�permit isstred in accor�nce wi�the Minnesota State ildir�g Code m�t 6�compieted w�th9rt°!80 days of pernt(t issuance. _ X��R ` } � .� . . . . . .. x �. . � ���. �. . � � . AAp�iicanf s Printed Name T ` ' arrt's�ignature ' Page 1 of 3